| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
833 |
798 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
231 |
225 |
$4K |
| V2020 |
Frames, purchases |
176 |
174 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
63 |
61 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
53 |
52 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
175 |
173 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$260.00 |